Legionnaires' disease outbreak investigation toolbox

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Published epidemiological analytical studies:

(M - matched; UM - unmatched case-control studies)

Study/paper

Case-control

Cohort

Seroprevalence

GIS

/spatial mapping

ADDISS D.G., DAVIS J.P., LAVENTURE M., WAND P.J., HUTCHINSON M.A., & MCKINNEY R.M. (1989) Community-acquired Legionnaires' disease associated with a cooling tower: evidence for longer-distance transport of Legionella pneumophila American Journal of Epidemiology 130(3), pp.557 - 568 http

BENIN A.L., BENSON R.F., ARNOLD K.E., FIORE A.E., COOK P.G., WILLIAMS L.K., FIELDS B., BESSER R.E. (2002) An outbreak of travel-associated Legionnaires' disease and Pontiac Fever: the need for enhanced surveillance of travel-associated legionellosis in the United States The Journal of Infectious Diseases 185, pp.237-43 http

BENKEL D. H., MCCLURE E. W., WOOLARD D., RULLAN J. V., MILLER JR G. B., JENKINS S. R., HERSHEY R. L., BETTY S. R. & BRIEMAN R. F. (2000) Outbreak of Legionnaires' disease associated with a display whirlpool spa International Journal of Epidemiology 29(6), pp. 1092 - 1098 http pdf

√ (M)

BEYRER K., LAI S., DREESMAN J., LEE J. V., JOSEPH C., HARRISON T., SURMAN-LEE S., LUCK C., BRODHUN B. & BUCHHOLZ U. & WINDORFER A. (2007) Legionnaires' disease outbreak associated with a cruise liner, August 2003: Epidemiological and microbiological findings Epidemiology and Infection 135, pp.802 - 810 http

√ (UM)

BOSHUIZEN H.C., NEPPELENBROEK S.E., VAN VLIET H., SCHELLEKENS J. F. P., DEN BOER J.W., PEETERS M.F. & CONYN-VAN SPAENDONCK M.A.E. (2001) Subclinical Legionella infection in workers near the source of a large outbreak of Legionnaires' disease The Journal of Infectious Diseases; 184, pp.515-8 http pdf

BROWN C. M., NUORTI P. J., BREIMAN R. F., HATHCOCK A. L., FIELDS B. S., LIPMAN H. B., LLEWELLYN G. C., HOFMANN J. & CETRON M. (1999) A community outbreak of Legionnaires' disease linked to hospital cooling towers: An epidemiological method to calculate dose of exposure International Journal of Epidemiology 28, pp.353-359 http pdf

√ (M)

CARR R., WARREN R., TOWERS L., BARTHOLOMEW A., DUGGAL H.V., REHMAN Y., HARRISON T.G. & OLOWOKURE B (2010) Investigating a cluster of Legionnaires' cases: public health implications Public Health 124 (6), pp. 326-331. http

√ (Proximity analysis/Overlay analysis)

CORREIA A. M., GONCALVES G., REIS J., CRUZ J. M. & CASTRO E FREITAS J. A. (2001) An outbreak of Legionnaires' disease in a municipality in northern Portugal Eurosurveillance 6(7), pp.21-24. http

DE SCHRIJVER K., DIRVEN K., VAN BOUWEL K., MORTELMANS L., VAN ROSSOM P., DE BEUKELAAR T., VAEL C., FAJO M., RONVEAUX O., PEETERS M. F., VAN DER ZEE A., BERGMANS A., IEVEN M. & GOOSSENS H. (2003) An outbreak of Legionnaire's disease among visitors to a fair in Belgium in 1999 Journal of the Royal Institute of Public Health 117, pp.117 - 124 http

DEN BOER J. W, YZERMAN P. F.E., SCHELLEKENS J., LETTINGA K. D, BOSHUIZEN H. C, VAN STEENBERGEN J. E, BOSMAN A., VAN DEN HOF S., VAN VLIET H. A, PEETERS M. F., VAN KETEL R. J., SPEELMAN P., KOOL J.L., & CONYN VAN SPAENDONCK M. A. E. (2002) A large outbreak of Legionnaires' disease at a flower show, the Netherlands, 1999 Emerging Infectious Diseases 8(1), pp.37-43 http pdf

DONDERO T.J., J.R., RENDTORFF R.C., MALLISON G.F., WEEKS R.M., LEVY J.S., WONG E.W., SCHAFFNER W. (1980) An outbreak of Legionnaires' Disease associated with a contaminated air-conditioning cooling tower The New England Journal of Medicine. 302(7), pp.365-370 http pdf

EDMOND-SMITH J. (2006) Report of the public meetings into the Legionella outbreak in Barrow-in-Furness, August 2002 Health and Safety Executive http pdf

FORMICA N., TALLIS G. F., ZWOLAK B., CARNIE J. A., BEERS M., HOGG G., RYAN N. J. & YATES M. (2000) Legionnaires' disease outbreak: Victoria's largest identified outbreak Communicable Diseases Intelligence 24(7), pp.199 - 202 http pdf

GARCIA-FULGUEIRAS A., NAVARRO C., FENOLL D., GARCIA J., GONZALEZ-DIEGO P., JIMENEZ-BUNUALES T., RODRIGUEZ M., LOPEZ R., PACHECO F., RUIZ J., SEGOVIA M., BALADRON B. & PELAZ C. (2003) Legionnaires' disease outbreak in Murcia, Spain Emerging Infectious Diseases 9(8), pp.915 - 921 http pdf

√ (Proximity analysis/Overlay analysis)

GREIG J. E., CARNIE J. A., TALLIS G. F., RYAN N. J., TAN A. G., GORDON I. R., ZWOLAK B., LEYDON J. A., GUEST C. S. & HART W. G. (2004) An outbreak of Legionnaires' disease at the Melbourne Aquarium, April 2000: investigation and case-control studies The Medical Journal of Australia. 180(11), pp.566-572. http

√ x 2

HUNT D. A., CARTWRIGHT K. A. V., SMITH M. C., MIDDLETON J., BARTLETT C. L. R., LEE J. V., DENNIS P. J. & HARPER D. (1991) An outbreak of Legionnaires' disease in Gloucester Epidemiology and Infection 107, pp.133-141 http

JERNIGAN D. B., HOFMANN J., CETRON M. S., NUORTI J. P., FIELDS B. S., BENSON R. F., BREIMAN R. F., LIPMAN H. B., CARTER R. J., GENESE C. A. & PAUL S. M., EDELSTEIN P. H. GUERRERO I. C. (1996) Outbreak of Legionnaires' disease among cruise ship passengers exposed to a contaminated whirlpool spa The Lancet. 347(9000) pp.494-499 http

KIRRAGE D., REYNOLDS G., SMITH G.E. & OLOWOKURE B; HEREFORD LEGIONNAIRES' OUTBREAK CONTROL TEAM (2007) Investigation of an outbreak of Legionnaires' disease: Hereford, UK 2003 Respiratory Medicine 101(8), pp.1639-1644 http

√ (Proximity analysis/Overlay analysis/Plume modelling)

NYGARD K., WERNER-JOHANSEN O., RONSEN S., CAUGANT D. A., SIMONSEN O., KANESTROM A., ASK E., RINGSTAD J., ODEGARD R., JENSEN T., KROGH T., HOIBY E. A., RAGNHILDSTVEIT E., AABERGE I. S. & AAVITSLAND P. (2008) An outbreak of Legionnaires' disease caused by long-distance spread from an industrial air scrubber in Sarpsborg, Norway Clinical Infectious Diseases 46(1), pp.61-69 http

√ (retro)

√ (Proximity analysis/Overlay analysis/Plume modelling)

NGUYEN T. M. N., ILEF D., JARRAUD S., ROUIL L., CAMPESE C., CHE D., HAEGHEBAERT S., GANIAYRE F., MARCEL F., ETIENNE J. & DESENCLOS J.C. (2006) A community-wide outbreak of Legionnaires' disease linked to industrial cooling towers: How far can contaminated aerosols spread? Journal of Infectious Diseases 193, pp.102-111 http

√ (M)

√ (Proximity analysis/Overlay analysis/Plume modelling)

O'LOUGHLIN R.E., KIGHTLINGER L., WERPY M. C., BROWN E., STEVENS V., HEPPER C., KEANE T., BENSON R.F., FIELDS B.S. & MOORE M.R. (2007) Restaurant outbreak of Legionnaires' disease associated with a decorative fountain: an environmental and case-control study BMC Infectious Diseases 7:93 http pdf

O'MAHONY M. C., STANWELL-SMITH R. E., TILLETT H. E., HARPER D., HUTCHINSON J. G. P., FARRELL I. D., HUTCHINSON D. N., LEE J. V., DENNIS P. J., DUGGAL H. V., SCULLY J. A. & DENNE C. (1990) The Stafford outbreak of Legionnaires' disease Epidemiology and Infection 104, pp.361 - 380 http

OKADA M., KAWANO K., KURA F., AMEMURA-MAEKAWA J., WATANABE H., YAGITA K., ENDO T. & SUZUKI S. (2005) The largest outbreak of legionellosis in Japan associated with spa baths: epidemic curve and environmental investigation Journal of the Japanese Association for Infectious Diseases 79, pp.365 - 374 http

PRAVINKUMAR S. J., EDWARDS G., LINDSAY D., REDMOND S., STIRLING J., HOUSE R., KERR J., ANDERSON E., BREEN D., BLATCHFORD O., MCDONALD E. & BROWN A. (2010) A cluster of Legionnaires' disease caused by Legionella longbeachae linked to potting compost in Scotland, 2008-2009 Eurosurveillance 15 (8), http pdf

ROTA M.C., PONTRELLI G., SCATURRO M., BELLA A., BELLOMO A.R., TRINITO M.O., SALMASO S. & RICCI M.L (2005) Legionnaires' disease outbreak in Rome, Italy Epidemiology and Infection 133 (5), pp. 853-859. http

√ (M)

SABRIA M., ALVAREZ J., DOMINGUEZ A., PEDROL A., SAUCA G., SALLERAS L., LOPEZ A., GARCIA-NUNEZ M. A., PARRON I. & BARRUFET M. P. (2006) A community outbreak of Legionnaires' disease: evidence of a cooling tower as the source Clinical Microbiology and Infectious Diseases 12, pp.642-647 http pdf

WATSON J. M., MITCHELL E., GABBAY J., MAGUIRE H., BOYLE M., BRUCE J., TOMLINSON M., LEE J. V., HARRISON T. G., UTTLEY A., O'MAHONY M. C., & CUNNINGHAM D. (1994) Piccadilly Circus Legionnaires' disease outbreak Journal of Public Health Medicine 16 (3), pp. 341-347. http